Association of COVID-19 vaccination with risks of hospitalization and mortality due to cardiovascular and other diseases: A study of the UK Biobank

BackgroundVaccines for COVID-19 represent a major breakthrough. However, worries about adverse effects led to vaccine hesitancy in some people. On the other hand, as COVID-19 may be associated with various sequelae, vaccination may protect against such sequelae via prevention of infections and severe disease. MethodsWe leveraged the UK-Biobank (UKBB) and studied associations of at least one dose of COVID-19 vaccination (BioNTech-BNT162b2 or Oxford-AstraZeneca-ChAdOx1) with short-term hospitalizations from cardiovascular and other selected diseases (N=393,544; median follow-up=54 days among vaccinated). Multivariable Cox and Poisson regression analyses were performed. We also performed adjustment using prescription-time distribution matching (PTDM) and prior-event rate ratio (PERR). PERR minimizes unmeasured confounding by comparing event hazards before introduction of vaccination. ResultsWe observed that COVID-19 vaccination(at least one dose), when compared to no vaccination, was associated with reduced short-term risks of hospitalizations from stroke(hazard ratio[HR]=0.178, 95% CI: 0.127-0.250, P=1.50e-23), venous thromboembolism (VTE) (HR=0.426, CI: 0.270-0.673, P=2.51e-4), dementia(HR=0.114, CI: 0.060-0.216; P=2.24e-11), non-COVID-19 pneumonia(NCP) (HR=0.108, CI: 0.080-0.145; P=2.20e-49), coronary artery disease (CAD) (HR=0.563, CI: 0.416-0.762; P=2.05e-4), chronic obstructive pulmonary disease (COPD) (HR=0.212, CI: 0.126-0.357; P=4.92e-9), type-2 diabetes (T2DM) (HR=0.216, CI: 0.096-0.486, P=2.12e-4), heart failure (HR=0.174, CI: 0.118-0.256, P=1.34e-18) and renal failure (HR=0.415, CI: 0.255-0.677, P=4.19e-4), based on Cox regression models. Among the above results, reduced hospitalizations for stroke, heart failure, NCP and dementia were consistently observed across all analyses, including regression/PTDM/PERR. ConclusionsTaken together, this study provides further support to the safety and benefits of COVID-19 vaccination, and such benefits may extend beyond reduction of infection risk or severity per se. However, causal relationships cannot be concluded and further studies are required to verify the findings.